LGBT Fertility Education: Causes of Female Infertility

Certain conditions can impact female fertility and any woman’s ability to conceive. Common causes include:

Blocked Fallopian Tubes
When blockage exists within one or both fallopian tubes, egg and sperm are prevented from meeting, thereby preventing natural conception. In addition to preventing conception, blocked fallopian tubes can also be the cause of ectopic pregnancy. Ectopic pregnancies are a dangerous condition in which a pregnancy, unable to move to the uterus for implantation, starts to grow within the tiny fallopian tube.

Salpingitis
Previously undetected or untreated infections, including sexually transmitted infections, can cause adhesions and scarring within the fallopian tubes.

Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) occurs when bacteria move from the vagina or cervix into the uterus, fallopian tubes, ovaries, or pelvis. Most cases of PID are due to the bacteria that cause Chlamydia and gonorrhea.

Hydrosalpinx
A hydrosalpinx is a fallopian tube that is filled with fluid. The fluid is somewhat toxic to early embryo development. Injury to the end of the fallopian tube (the ampulla) and its delicate fingers (the fimbria) causes the end of the tube to close. Hydrosalpinx interferes with fertility treatment and decreases chances for successful in vitro fertilization (IVF). Use of fertility drugs can unwittingly increase the fluid build-up within undetected hydrosalpinx. The most common causes of hydrosalpinx are undiagnosed or untreated Chlamydia and gonorrhea. Other possible causes are use of IUDs, endometriosis, and abdominal surgery.

Ovarian Cysts
A cyst is a fluid-filled sac. Most ovarian cysts are benign (not cancerous). They usually disappear on their own and produce no symptoms. The normal ovary can have small cysts leftover from ruptured egg follicles. Some ovarian cysts, however, are associated with problems such as abdominal or pelvic pain, spotting between menstrual periods, and/or infertility.

• Hemorrhagic cyst - occurs when bleeding is also present
• Dermoid cyst - comprised of the same tissue as skin, fat, bone, hair, or cartilage; may become inflamed or cause ovarian torsion (twisting)
• Endometrioid cyst - caused by endometriosis, a common cause of female infertility
• Polycystic ovary - usually twice its normal size with many small cysts on the outside; present in women with and those without polycystic ovary syndrome

Fibroid Tumors
Many women have benign (non-cancerous) tumors in their uterus called myomata uteri or fibroids. These myoma may be silently present and cause no problems. For some women, however, fibroids can cause excessive and frequent menstrual periods, pelvic pain, infertility, and recurrent pregnancy loss.

As a result of excessive uterine bleeding fibroid tumors can lead to severe anemia. Other symptoms can include pelvic pressure on the bladder or rectum which may cause frequent urination or constipation. Some women will experience pain during vaginal penetration (due to an enlarged uterus).

Benign fibroids can be removed surgically through procedures known as laparoscopic or hysteroscopic myomectomy.

This information is provided by Boston IVF for general education purposes and is not intended to take the place of a discussion with your physician. If you have questions about any aspect of your health, you are advised to speak with your physician.